CAJ | 학술논문

目的：探讨臂踝动脉脉搏波速度在诊断非缺血性射血分数保留心力衰竭（心衰）中的价值。方法：因呼吸困难住院的非冠心病患者86例，分射血分数保留心衰组即实验组（n=46）和对照组（n=40），测量超声心动图、B型利钠肽和臂踝动脉脉搏波速度等指标。采用Logistic回归模型、指标联合接受者操作特性曲线（ROC）和净重分类指数评估臂踝脉搏波速度能否改善上述指标对射血分数保留心衰的诊断效果。结果：经多元逐步Logistic分析，二尖瓣舒张早期流速与侧壁瓣环组织多普勒速度比值、B型利钠肽和臂踝脉搏波速度对射血分数保留心衰有独立预测价值（P<0.05）。臂踝脉搏波速度与前两个指标两两组合或三个指标联合的ROC曲线下面积明显高于单一指标（P<0.05）。臂踝脉搏波速度加入2007欧洲心脏病协会（ESC）共识后，明显提高该标准的诊断效果（NRI=0.127，P<0.05）。结论：臂踝动脉脉搏波速度结合现有的诊断指标或标准，能改善对射血分数保留心力衰竭的诊断效果。
목적：탐토비과동맥맥박파속도재진단비결혈성사혈분수보류심력쇠갈（심쇠）중적개치。방법：인호흡곤난주원적비관심병환자86례，분사혈분수보류심쇠조즉실험조（n=46）화대조조（n=40），측량초성심동도、B형리납태화비과동맥맥박파속도등지표。채용Logistic회귀모형、지표연합접수자조작특성곡선（ROC）화정중분류지수평고비과맥박파속도능부개선상술지표대사혈분수보류심쇠적진단효과。결과：경다원축보Logistic분석，이첨판서장조기류속여측벽판배조직다보륵속도비치、B형리납태화비과맥박파속도대사혈분수보류심쇠유독립예측개치（P<0.05）。비과맥박파속도여전량개지표량량조합혹삼개지표연합적ROC곡선하면적명현고우단일지표（P<0.05）。비과맥박파속도가입2007구주심장병협회（ESC）공식후，명현제고해표준적진단효과（NRI=0.127，P<0.05）。결론：비과동맥맥박파속도결합현유적진단지표혹표준，능개선대사혈분수보류심력쇠갈적진단효과。
Objective: To explore the diagnostic value of brachial-ankle artery pulse wave velocity (baPWv) in patients of heart failure with preserved ejection fraction (HFpEF). Methods: A total of 86 consecutive dyspnoea patients without coronary artery diseases (CAD) were studied and they were divided into 2 groups: HFpEF group,n=46 and Control group, the patients had no organic heart disease,n=40. The incremental diagnostic value of HFpEF by baPWv improving the echocardiographic index and plasma BNP level was assessed by logistic regression model, receiver operation curve (ROC) of multi-parameter combination and net reclassiifcation index analysis. Results: Multiple stepwise logistic regression analysis presented that the ratio of early mitral inlfow velocity to tissue Doppler velocity at the lateral mitral annulus, BNP level and baPWv had the independent predictive value for HFpEF diagnosis, P<0.05. The ROC for baPWv with the combination of 2 or 3 parameters was better than the ROC for a single parameter, P<0.05. The baPWv added with 2007 ESC consensus statement signiifcantly improved HFpEF diagnosis, NRI = 0.127,P<0.05. Conclusion: The baPWv combining with current diagnostic criteria could increase the diagnostic value in patients of HFpEF.